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Risk of Extreme, Moderate, and Late Preterm Birth by Maternal Race, Ethnicity, and Nativity - 21/12/21

Doi : 10.1016/j.jpeds.2021.09.035 
Teniola I. Egbe, MPH, MBE 1, , Diana Montoya-Williams, MD 2, 3, 4, , Kate Wallis, MD, MPH 2, 3, 5, Molly Passarella, MS 4, Scott A. Lorch, MD, MSCE 2, 3, 4
1 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 
2 Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 
3 CHOP PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, PA 
4 Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA 
5 Division of Developmental and Behavioral Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 

Reprint requests: Teniola I. Egbe, MPH, MBE, Children’s Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South St, 10th Floor–10264, Philadelphia, PA 19146Children’s Hospital of PhiladelphiaRoberts Center for Pediatric Research2716 South St10th Floor–10264PhiladelphiaPA19146

Abstract

Objectives

To explore the relative risks of preterm birth—both overall and stratified into 3 groups (late, moderate, and extreme prematurity)—associated with maternal race, ethnicity, and nativity (ie, birthplace) combined.

Study design

This was a retrospective cross-sectional cohort study of women delivering a live birth in Pennsylvania from 2011 to 2014 (n = 4 499 259). Log binomial and multinomial regression analyses determined the relative risks of each strata of preterm birth by racial/ethnic/native category, after adjusting for maternal sociodemographic, medical comorbidities, and birth year.

Results

Foreign-born women overall had lower relative risks of both overall preterm birth and each strata of prematurity when examined en bloc. However, when considering maternal race, ethnicity, and nativity together, the relative risk of preterm birth for women in different racial/ethnic/nativity groups varied by preterm strata and by race. Being foreign-born appeared protective for late prematurity. However, only foreign-born White women had lower adjusted relative risks of moderate and extreme preterm birth compared with reference groups. All ethnic/native sub-groups of Black women had a significantly increased risk of extreme preterm births compared with US born non-Hispanic White women.

Conclusions

Race, ethnicity, and nativity contribute differently to varying levels of prematurity. Future research involving birth outcome disparities may benefit by taking a more granular approach to the outcome of preterm birth and considering how nativity interacts with race and ethnicity.

Le texte complet de cet article est disponible en PDF.

Keywords : preterm birth, immigrant health, health disparities

Abbreviation : aRR


Plan


 Supported by internal professional development funds from Children's Hospital of Philadelphia. The authors declare no conflicts of interest.
 Portions of this study were presented at the National Conference and Exhibition of the American Academy of Pediatrics, October 25th, 2019, New Orleans, LA; and the American Public Health Association Conference, November 5th, 2019, Philadelphia, PA.


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Vol 240

P. 24 - janvier 2022 Retour au numéro
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